Analysis Of Clinical Characteristics Of Depression Patients With Co-Morbid Possession Trance Disorder

Background:Possession trance disorder(PTD)is classified as a dissociative disorder in the newly published ICD-11,but its definition and clinical features are still unclear.The main characteristic of this disorder is the experience of the individual’s behavior or movement being controlled by the "possessed agents",which is manifested as a state of disorientation,often accompanied by a significant change in the individual’s state of consciousness or the replacement of the individual’s original identity by the identity of the external "possessed agents".In clinical practice,it was found that some patients in the northeast of China presented with complaints of "difficulty sleeping","depressed mood",and "diminished interest".These patients are often diagnosed as depressive disorder and given antidepressant treatment;a careful psychiatric examination may reveal a history of possession trance disorder.For such patients,antidepressant treatment only is often not effective enough.Therefore,early identification of these patients and effective treatment are clinically important to improve their prognosis.Objectives:This study intends to investigate the demographic characteristics as well as clinical features of patients with depressive disorders with co-morbid possession trance disorder,so as to provide a reference for the identification of such patients in clinical practice.As well as to statistically analyze the different symptomatic manifestations of PTD patients during the course of the disease and to provide clinical data for further revision of PTD diagnostic criteria.Methods:75 patients attending the inpatient departments of the Department of Mental Health at the First Hospital of Jilin University from June 2021 to June 2022 were collected;25 patients with MDD,a co-morbidity of PTD,were the case group and 50 patients with MDD were the control group.The demographic characteristics(including age,gender,education level,marital status,family history,etc.),clinical characteristics(type of symptoms,number of symptoms,time from onset to first consultation,and triggers of episodes,etc.),and special information(religious beliefs,whether they had seen a "witch doctor" "Tai Sin" or not,etc.)of the patients in both groups were collected through electronic case reviews,telephone follow-ups,and interviews.We compared the demographic characteristics,clinical characteristics and culturally relevant background differences between the two groups,and statistically described the core symptoms,concomitant symptoms and other clinical characteristics of PTD patients with episodes of possession.Results:1.There was no statistical difference between the case and control groups in terms of general information(age,age of onset,gender,family history of mental disorders,education level,and presence of onset triggers)(P>0.05).2.The proportion of married persons was significantly higher in the case group than in the control group(P<0.05).3.Patients in the case group more often had symptoms of controlled experience,self-talk,auditory hallucinations,visual hallucinations,emotional outbursts,crying and laughing disorders,and altered voice and demeanor(P<0.05),and less often were accompanied by suicide(thoughts/behaviors),self-injury(thoughts/behaviors),social withdrawal,and sleep disturbance(P<0.05).4.Patients in the case group were more often located in rural areas(P<0.05),more often had religious beliefs(P<0.05),and more often had seen a "witch doctor" or "daisy" for treatment(P<0.05).Conclusion:1.No significant differences were found between depressive disorder patients with co-morbid possession trance disorder and depressive disorder patients with ordinary depressive disorder in terms of literacy,age,and gender.2.Compared with depressed patients in control group,depressed disorder patients with co-morbid possession trance disorder had more psychotic symptoms and higher symptom burden during their depressive episode.